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Neurology 2001;56:1762-1765
© 2001 American Academy of Neurology
Brief Communications

Clinical aspects of multifocal or generalized tonic dystonia in reflex sympathetic dystrophy

J.J. van Hilten, MD, PhD;, W.J.T. van de Beek, MSc;, A.A. Vein, MD, PhD;, J.G. van Dijk, MD, PhD; and H.A.M. Middelkoop, PhD

From the Department of Neurology, Leiden University Medical Center, the Netherlands.

Address correspondence and reprint requests to Dr. J.J. van Hilten, Department of Neurology, Leiden University Medical Center, P.O. Box 9600, 2300 RC Leiden, the Netherlands; e-mail: jvhilten{at}LUMC.nl

The authors describe 10 patients with reflex sympathetic dystrophy that progressed to a multifocal or generalized tonic dystonia. The neuropsychologic profile was similar to that of other patients with chronic pain, irrespective of its cause. The distribution pattern of dystonia, the stretch reflex abnormalities, and the worsening of dystonia after tactile and auditory stimuli suggest impairment of interneuronal circuits at the brainstem or spinal level. Antibody titers for glutamic acid decarboxylase, tetanus, and Sjögren antigens were all normal.




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